UAB - Center for Clinical and Translational Science

Study of Lenacapavir for HIV Pre-Exposure Prophylaxis in People Who Are at Risk for HIV Infection

Purpose

The goal of this clinical study is to test how well the study drug, lenacapavir (LEN), works in preventing the risk of HIV.

Condition

Pre-Exposure Prophylaxis of HIV Infection

Eligibility

Eligible Ages: Over 16 Years
Eligible Genders: All
Accepts Healthy Volunteers: Yes

Inclusion Criteria

Incidence Phase - CGM, TGW, TGM, and GNB who have condomless receptive anal sex with partners assigned male at birth and are at risk for HIV infection. - HIV-1 status unknown at screening and no prior HIV-1 testing within the last 3 months. - Sexually active with ≥ 1 partner assigned male at birth (condomless receptive anal sex) in the last 12 months and 1 of the following: - Condomless receptive anal sex with ≥ 2 partners in the last 12 weeks. - History of syphilis, rectal gonorrhea, or rectal chlamydia in the last 24 weeks. - Self-reported use of stimulants with sex in the last 12 weeks. Randomized Phase - Negative local rapid fourth generation HIV-1/2 Ab/Ag, central fourth generation HIV-1/2 Ab/Ag, and HIV-1 RNA quantitative nucleic acid amplification testing (NAAT). - Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min at screening according to the Cockcroft-Gault formula for creatinine clearance (CLcr).

Exclusion Criteria

Incidence Phase - Prior use of HIV PrEP (including F/TDF or F/TAF) or HIV postexposure prophylaxis (PEP) in the past 12 weeks or any prior use of long-acting systemic PrEP (including cabotegravir or islatravir). - Prior recipient of an HIV vaccine or HIV broadly neutralizing antibody formulation. Randomized Phase - Acute viral hepatitis A, B or C or evidence of chronic hepatitis B or C infection. - Severe hepatic impairment or a history of or current clinical decompensated liver cirrhosis. Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Study Design

Phase: Phase 3
Study Type: Interventional
Allocation: Randomized
Intervention Model: Parallel Assignment
Primary Purpose: Treatment
Masking: Double (Participant, Investigator)

Arm Groups

Arm	Description	Assigned Intervention
Experimental Blinded Phase: LEN + Placebo-to-match (PTM) F/TDF	Participants will receive the following for approximately 52 weeks: - Subcutaneous (SC) lenacapavir (LEN) 927 mg every 26 weeks - Oral PTM Emtricitabine/Tenofovir Disoproxil Fumarate (F/TDF) once daily - Oral LEN 600 mg on Days 1 and 2 Participants will receive oral LEN if SC injections are not available	Drug: Oral Lenacapavir (LEN) Tablets administered orally without regard to food Other names: GS-6207 Drug: Sub-cutaneous (SC) Lenacapavir (LEN) Administered via SC injections Other names: GS-6207 Drug: PTM F/TDF Tablets administered orally
Experimental Blinded Phase: Placebo LEN + F/TDF	Participants will receive the following for approximately 52 weeks: - SC LEN placebo every 26 weeks - Oral F/TDF 200/300 mg once daily - PTM Oral LEN on Days 1 and 2 Participants will receive oral LEN placebo if SC injections are not available	Drug: F/TDF Tablets administered orally Other names: Truvada® Drug: Placebo SC LEN Administered via SC injections Drug: PTM Oral LEN Tablets administered orally
Experimental LEN Open-Label Extension (OLE) Phase	Participants will be offered entry into the LEN OLE Phase, following the completion of primary analysis, if LEN demonstrates acceptable safety and efficacy in the Randomized Blinded Phase. Participants randomized to LEN will continue to receive SC LEN 927 mg, every 26 weeks (± 7 days), and have study visits every 13 weeks (± 7 days). Participants randomized to F/TDF will switch to SC LEN 927 mg on OLE Day 1, Week 26 and every 26 weeks thereafter. Participants will also receive oral LEN 600 mg on OLE Days 1 and 2. All participants in the LEN OLE Phase will complete the phase, once LEN becomes available or the sponsor decides to discontinue the study, whichever happens first. After completing the LEN OLE Phase or study discontinuation, participants will transition to local PrEP, including LEN or other options. If a participant exits early, they will complete an ESDD visit, be referred to local PrEP services if needed, and have a 30-day follow-up visit.	Drug: Oral Lenacapavir (LEN) Tablets administered orally without regard to food Other names: GS-6207 Drug: Sub-cutaneous (SC) Lenacapavir (LEN) Administered via SC injections Other names: GS-6207
Experimental PK Tail Phase	Participants who prematurely discontinue study drug during blinded phase and participants that were randomized to LEN who choose not to continue in the LEN OLE Phase will transition to the PK Tail Phase. Participants will receive oral F/TDF (or Emtricitabine/Tenofovir Alafenamide (F/TAF) for US participants only) once daily for 78 weeks to cover the PK tail and complete visits every 13 weeks (+/- 7 days). Upon unblinding, participants who were randomized to F/TDF in the Randomized Blinded Phase who decline to participate in the LEN OLE Phase will complete the ESDD visit, transition to local HIV prevention services, and return for a 30-day follow-up visit.	Drug: F/TDF Tablets administered orally Other names: Truvada® Drug: F/TAF (for US participants only) F/TAF tablets administered orally once daily

More Details

Status: Active, not recruiting
Sponsor: Gilead Sciences

Study Contact

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.